Provider Demographics
NPI:1922162668
Name:TRIPLETT, RONALD L (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:TRIPLETT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11600 MANCHESTER RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-4691
Mailing Address - Country:US
Mailing Address - Phone:314-909-1717
Mailing Address - Fax:314-909-6681
Practice Address - Street 1:11600 MANCHESTER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-4691
Practice Address - Country:US
Practice Address - Phone:314-909-1717
Practice Address - Fax:314-909-6681
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO144451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice